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Urinary Actin, as a Potential Marker of Sepsis-related Acute Kidney Injury

Completed
Conditions
Acute Kidney Injury Due to Sepsis
Sepsis
Interventions
Other: Sepsis therapy
Other: Sepsis-related acute kidney injury therapy
Registration Number
NCT04968262
Lead Sponsor
University of Pecs
Brief Summary

In our study, 17 septic, 43 sepsis-related acute kidney injury and 24 control patients were enrolled. Blood and urine samples were collected at the intensive care unit from acutely diagnosed septic and sepsis-related acute kidney injury patients at three time points (T1-3): T1: within 24 hours after admission; T2: second day morning; T3: third day morning of follow-up. Patients with malignancies needing palliative care, end-stage renal disease or kidney transplantation were excluded. Not more than one sample (venous blood, midstream spot urine) was collected from control patients. Serum and urinary actin levels were determined by quantitative Western blot. Urinary actin concentrations were expressed as µg/L, while serum actin levels were expressed as mg/L. Data were compared with laboratory and clinical parameters. Patients were categorized by the Sepsis-3 definitions and 30-day mortality data were investigated.

Detailed Description

Actin is a globular protein present in every cell with a 42 kilodalton molecular mass. It plays an important role in muscle contraction while being an essential component of the cytoskeleton as well. Several proteins (e.g. gelsolin, Gc-globulin) bind actin in the circulation during the physiological cell turnover, thus making its urinary appearance unlikely. However, recent studies indicate that actin could be detected in the urine of kidney-transplant patients with acute kidney injury. Therefore, the main focus of our research was the detection and measurement of actin in the blood and urine in patients with sepsis or sepsis-related acute kidney injury, as the early recognition of kidney injury - especially in sepsis - is essential in the aspect of therapy and survival.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
84
Inclusion Criteria
  • Sepsis
  • Sepsis-related acute kidney injury
Exclusion Criteria
  • malignancies needing palliative care
  • end-stage renal disease
  • kidney transplantation
  • under 18 years of age
  • unobtainable consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
SepsisSepsis therapyPatients receive sepsis therapy.
Sepsis-related acute kidney injurySepsis-related acute kidney injury therapyPatients receive sepsis and sepsis-related acute kidney injury therapy.
Primary Outcome Measures
NameTimeMethod
Serum actin concentrations3 days

Clotted blood samples were centrifuged (10 min, 1500 g) and supernatants were treated with electrophoresis sample buffer then heated at 100 °C for 5 minutes. Serum actin was determined by quantitative Western blot. Native and denatured sample aliquots were stored at -70 °C until analysis.

Urinary actin concentrations3 days

Urine samples were centrifuged (10 min, 1500 g) and supernatants were treated with electrophoresis sample buffer then heated at 100 °C for 5 minutes. Urinary actin was determined by quantitative Western blot. Native and denatured sample aliquots were stored at -70 °C until analysis.

Secondary Outcome Measures
NameTimeMethod
U-actin/u-creatinine concentrations5 days

U-actin values were determined by quantitative Western blot, while U-creatinine concentrations were measured using automated routine laboratory procedures, therefore U-actin/u-creatinine ratios could be calculated.

Trial Locations

Locations (1)

Department of Anesthesiology and Intensive Therapy, Medical School, University of Pécs

🇭🇺

Pécs, Baranya, Hungary

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